Comparison of PPIs and H_2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia  

作　　者：Masahiro Sakaguchi Miyuki Takao Yasuo Ohyama Hiroshi Oka Hiroshi Yamashita Takumi Fukuchi Kiyoshi Ashida Masahiro Murotani Masuyo Murotani Kazuo Majima Hiroshi Morikawa Takashi Hashimoto Keisuke Kiyota Hirohiko Esaki Kanji Amemoto Gouhei Isowa Fumiyuki Takao 

机构地区：[1]Department of Gastroenterology,Moriguchi Keijinkai Hospital,Moriguchi,Osaka 570-0021,Japan [2]Department of Gastroenterology,Osaka Saiseikai Nakatsu Hospital,Osaka 530-0012,Japan [3]Murotani Clinic,Kadoma,Osaka 571-0008,Japan [4]Majima Clinic,Neyagawa,Osaka 572-0084,Japan [5]Morikawa Clinic,Hirakata,Osaka 573-0058,Japan [6]Hashimoto Clinic,Moriguchi,Osaka 570-0079,Japan [7]Kiyota Clinic,Matsubara,Osaka 580-0004,Japan [8]Department of Gastroenterology,Arisawa General Hospital,Hirakata,Osaka 573-1195,Japan [9]Amemoto Clinic,Moriguchi,Osaka 570-0021,Japan [10]Isowa Clinic,Neyagawa,Osaka 572-0062,Japan [11]Mii Clinic,Neyagawa,Osaka 572-0019,Japan

出　　处：《World Journal of Gastroenterology》2012年第13期1517-1524,共8页世界胃肠病学杂志（英文版）

摘　　要：AIM： To compare efficacy of proton pump inhibitors （PPIs） with H2-receptor antagonists （H2RA$） plus pro- kinetics （Proks） for dysmotility-like symptoms in func- tional dyspepsia （FD）. METHODS： Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od （n = 57） or famotidine 10 mg bid plus mosapride 5 mg tid （n = 57） for 4 wk. The primary efficacy endpoint was change （%） from baseline in total dysmotility-like dyspepsia symptom score. The secondary efficacy endpoint was patient satisfaction with treatment. RESULTS： The improvement in dysmotility-like dyspep- sia symptom score on day 28 was significantly greater in the rabeprazole group （22.5% ± 29.2% of baseline） than the famotidine ＋ mosapride group （53.2%±58.6% of baseline, P 〈 0.0001）. The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status. Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine ＋ mosapride group （87.7% vs 59.6%, P = 0.0012）. Rabeprazole therapy was the only significant predictor of treatment response （P 〈 0.0001）, defined as a total symptom score improvement ≥ 50%. CONCLUSION： PPI monotherapy improves dysmotil- ity-like symptoms significantly better than H2RAs plus Proks, and should be the treatment of first choice for Japanese FD.AIM:To compare efficacy of proton pump inhibitors(PPIs)with H2-receptor antagonists(H2RAs)plus prokinetics(Proks)for dysmotility-like symptoms in functional dyspepsia(FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od(n= 57)or famotidine 10 mg bid plus mosapride 5 mg tid(n=57)for 4 wk.The primary efficacy endpoint was change(%)from baseline in total dysmotility-like dyspepsia symptom score.The secondary efficacy endpoint was patient satisfaction with treatment.RESULTS:The improvement in dysmotility-like dyspep-sia symptom score on day 28 was significantly greater in the rabeprazole group(22.5%±29.2%of baseline) than the famotidine+mosapride group(53.2%± 58.6%of baseline,P<0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status.Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine+mosapride group(87.7%vs 59.6%,P= 0.0012).Rabeprazole therapy was the only significant predictor of treatment response(P<0.0001),defined as a total symptom score improvement≥50%.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.

关 键 词：DYSMOTILITY Functional dyspepsia H2-recep-tor antagonist PROKINETICS Proton pump inhibitor 

分 类 号：R96[医药卫生—药理学]